Common Conditions of the Eyes & Ears

Question 1

What is important to know about using eye drops and ear drops?

Answer 1

• Eye dropsCAN be used in the Ear but NEVER Ear drops in the Eye

Due to pH and sterility

Question 2

What do the abbrevations of the Ear/Eye drop sigs mean?

AD, AS, AU; OD, OS, OU?

Answer 2

• AD: Right Ear
• AS: Left Ear
• AU: Both Ears
• OD: Right Eye
• OS: Left Eye
• OD: Both Eyes

Question 3

What is important to know about the Formulations of the Eyes/Ear Drops?

Answer 3

• Solutions: 1 drop = 0.05 mL
• Suspension: Shake well
• Ointment: Blurry Vision
• Gel: Invert and Shake ONCE

Question 4

What is Glaucoma and what are the 2 main types?

Answer 4

• Glaucoma: Damages to the optic nevere and loss of vision due to increased intraocular pressure
• Open & Closed Angle

Question 5

What are some drugs that can cause an increase in IOP?

Answer 5

• Anticholinergics [antihistamines, oxybutynin, tolterodine, benztropine…]
• Decongestants [Pseudoephrine]
• Steroids [Prednisolone]
• Topiramate

Question 6

What is the difference between the 2 types of Glaucoma?

Answer 6

• Open: No symptoms
• Closed: Sudden increase in IOP due to blockages [medical emergency and needs surgery]

Question 7

What is the target that drug treatments act on in Glaucoma and what are the 2 common drug types?

Answer 7

• To decrease IOP by targeting aqueous humor
• Prostaglandin Analongs [best] and Beta-Blockers [best in one eye]

Question 8

What is the treatment strategies for Glaucoma?

Answer 8

• Reduce Aqueous Humor production [BB +/- Carbonic Anhydrase Inhibitor]
• Increase Aqueous Humor Outflow [Prostaglandin Analogs]
• BOTH [Alpha 2 Agonist]

Question 9

What are the Prostaglindin Analogs that are used for the treatment of Glaucoma?

Answer 9

• Bimatoprost [Lumigan]
• Latanoprost [Xalatan, Xelpros]
• Travoprost [Travatan Z]
• Binatoprost [Latisse] - for eyelash growth

Question 10

What are the warnings for the Prostaglandin Analogs in the treatment of Glaucoma?

Answer 10

• Darkening of Iris/Eyelashes
• Eyelash growth

Question 11

What are the Side Effects of the Prostaglandin Analogs used in the treatment of Glaucoma?

Answer 11

• Blurred Vision
• Stinging
• Increased Pigmentation of the Iris/Eyelash
• Eyelash Growth

Question 12

What are the Beta-Blockers that are used in the treatment of Glaucoma?

Answer 12

• Timolol 0.25% & 0.5% [Timoptic, Timoptic-XE, Istalol] 1 drop QD or BID
• • Dorzolamide [Cosopt, Cospot PF]

Reduce Aqueous Humor Production
Gels: Shake ONCE then wait 10 mins

Question 13

What are the side effects of the Beta-Blockers used for the treatment of Glaucoma?

Answer 13

• Burning
• Stinging
• Bradycardia/Fatigue
• Bronchospasms

NON-SELECTIVE except Betaoxlol

Question 14

What are the Cholinergics (Miotics) that are used in the treatment of Glaucoma?

Answer 14

• Carbachol [Miostat]
• Pilocarpine [Isopto Carpine]

Increases aqueous humor outflow

Question 15

What are the side effects of the Cholinergics that are used in the treatment of Glaucoma?

Answer 15

• Poor Vision … at night [Pupil contraction]

Question 16

What are the Carbonic Anhydrase Inhibitors that are used in the treatment of Glaucoma?

Answer 16

• Dorolamide [Trusopt] (+ Timolol [Cosopt, Cosopt PF])
• Brinzolamide [Azopt] (+ Brimonidine [Simbrinza])
• Acetazolamide - Oral, Injection
• Methazolamide - Oral

Reduce Aqueous Humor Production
Acetazolamide used more in MOTION SICKENSS

Question 17

What are the Adrenergic Alpha-2 Agonists that are used in the treatment of Glaucoma?

Answer 17

• Brimonidine [Alpagan P] (+ Timolol [Combigan]; + Brinzolamide [Sibmbrinza])
• Apraclonidine
• Brimonidine [Lumify] OTC for redness

Increase aqueuos humor outflow & Reduce aqueous humor Production

Question 18

What are the Rho Kinase Inhibitors that are used for the treatment of Glaucoma?

-

Answer 18

• Netarsudil [Rhopressa]
• • Latanoprost

Increase aqueous humor outflow

Question 19

What is Conjunctivitis and what are some of the ways that it is caused?

Answer 19

• “Pink Eye” that causes swelling, itching, itching, burning, and redness
• caused by Virus, Bacteria, Allergen, Irritants

More common in kids and HIGHLY CONTAGIOUS

Question 20

What are some of the ways that the prevention of Conjunctivitis can be stopped?

Answer 20

• AVOID touching eyes
• Hand Hygine
• Change Towels and washcloths DAILY
• Discard eye cosmetics

Question 21

What are some of the causes and treatments for Viral Conjunctivits?

Answer 21

• Causes: Adenovirus
• Treat: NO Topical treatment

Question 22

What are some of the causes and treatments for Bacterial Conjunctivitis?

Answer 22

• Causes: S. Aureus, Strep Pneumo, H. Flu, M. Cat [Chlamydia or N. Gonorrhoeae if severe]
• Treat: Moxifloxacin [Vigamox], Neomycin/Polymixin B/Dexamethasone [Mexitrol], Ofloxacin [Ocuflox], Trimethoprim/Polymixin B [Polytrim]

Question 23

What are some of the causes and treatments for Allergic Conjunctivits?

Answer 23

• Causes: Allergens
• Treat: Cromolyn, Azelastine, Olopatadine [Pataday], Ketotifen

Question 24

What is Blepharitis?

Answer 24

• Eyelid inflammation

Question 25

What are some of the **Treatment** options for **inflammation** as a **symptom-based issue**

Answer 25

- Prednisolone [Pred Forte, Pred Mild] - Ketorloc [Acular] - Cold Compress ## Footnote Increase risk to **INCREASE IOP** **MAINLY USED IF SEVERE**

Question 26

What are some of the **Treatment** options for **dryness** as a **symptom-based issue**

Answer 26

- Refresh [OTC] - Systane [OTC] ## Footnote "Artifical Tears"

Question 27

What are some of the **Treatment** options for **Chronic Dry Eye Disease** as a **symptom-based issue**

Answer 27

- Cyclosporine Emulsion Eye Drops [**Restasis**]

Question 28

What are some of the **Treatment** options for **Redness** as a **symptom-based issue**

Answer 28

- Naphazoline [Clear Eyes Redness Relief] OTC - Naphazoline/Pheniramine [Naphcon A, Visine A] OTC - Tetrahydrozoline [**Visine**] OTC

Question 29

What are some common drugs that are known to cause **Retinal chagnes/retinopathy**?

Answer 29

- Chloroquine - Hydroxychloroquine

Question 30

What are some common drugs that are known to cause **Optic Neuropathy**?

Answer 30

- Amiodarone - Ethambutol - Linezolid

Question 31

What are some common drugs that are known to cause **Intraoperative floppy iris syndrome (IFIS): causes difficulty in cataract surgery**?

Answer 31

- Alpha-Blockers [Tamsulosin]

Question 32

What are some common drugs that are known to cause **Color Discrimination**?

Answer 32

- Digoxin - Yellow/green vision - PDE-5 Inhibitors - Greenish - Voriconazole

Question 33

What are some common drugs that are known to cause **Vision loss/abnormal vision**?

Answer 33

- Digoxin - blurriness, halos - PDE-5i - Isotretinoin - decrease night vision - Topiramate - Vigabatrin - PERMANENT vision loss - Voriconazole

Question 34

What are some of the common ear conditions?

Answer 34

- Too much Ear Wax - Tinnititis [caused by drug toxicity or noise exposure]

Question 35

What is the way that **Ear Wax Blockade** can be **treated**?

Answer 35

- Carbamide Peroxide [Debrox]

Question 36

What is the way that we can **treat otitis externa**?

Answer 36

- Mild Cases: Acetic acid & a gloucocorticoid [VoSol HC] - ABX: Ciprofloxacin